This form is by the plaintiff's attorney to request from client's medical provider information regarding the client's injuries and treatment.
Letter regarding Client's Injuries and Diagnosis
State:
Multi-State
Control #:
US-PI-0259
Format:
Word;
Rich Text
Instant download
Description Regarding Client
How to fill out Letter Regarding Client's Injuries And Diagnosis?
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FAQ
Date, time, and specific location of incident. Names, job titles, and department of employees involved and immediate supervisor(s) Names and accounts of witnesses. Events leading up to incident. Exactly what employee was doing at the moment of the accident.
The opening paragraph states the legal issue the letter is addressing followed by the facts, a discussion of the law as it applies to the facts and a conclusion which is essentially the advice to the client. Often attorneys include headings to lead the client through this process to arrive at the same conclusion.
Type your letter. Concisely review the main facts. Be polite. Write with your goal in mind. Ask for exactly what you want. Set a deadline. End the letter by stating you will promptly pursue legal remedies if the other party does not meet your demand. Make and keep copies.
Indicate at the start of the letter that you're making a claim then specify the type of claim you're making. If applicable indicate the policy number. Explain the specific details or circumstances of your claim.
Sir/Madam, I, _______________ (Patient Name), son of/ daughter of/ wife of _______________ residing at ( Address) hereby confirm that I was ________ (what your were doing at the time of accident) when suddenly __________ (reason of accident) and accident took place at __________ (location where accident taken place).
Type of incident (injury, near miss, property damage, or theft) Location (Address) Date/time of incident. Name. Name of supervisor. Description of the incident, including specific job site location, the sequence of events, and the results of the event.
Say who you are. Set out the accident circumstances. Allege negligence or fault or breach of statute. Describe your injuries and financial losses. Request sight of relevant documentation. Nominate medical experts.
DON'T Write War and Peace. DO Highlight Unique Facts About Your Case. DON'T Send the Demand by Certified Mail. DO Differentiate Your Case. DON'T Make a Specific Settlement Demand. DO Demand Policy Limits. DON'T Go Over-the-Top. DO Make Clear the Case Will Not Settle Unless2026
